[Emphysematous pyelitis: epidemiological, therapeutic and evolutive features]

Emphsematous pyelitis is an uncommon form of acute pyelonephritis. It has been reported sporadically in the literature. Our objective is to study the epidemiological, clinical and therapeutic characteristics of emphysematous pyelitis. The-data-of six patients- managed-for emphysematous-pyelitis were collected and analyzed. The mean age was 55 years. Urinary lithiasis and diabetes were the most common co-morbidities. Febrile lumbar pain and general health impairment were the presenting symptoms in five patients; the remaining case presented with septic shock. Urine and blood culture grew E. Coli in 4 and 3 cases respectively. Computed tomography of the abdomen led to diagnosis by showing gas images in the collecting system. Treatment consisted of antibiotics associated with collecting system drainage. It avoided emergent nephrectomy in all cases. The treatment of the calculi was held at distance from the infection. Nephrectomy was done in one patient presenting a thinned - dedifferentiated - renal parenchyma. Outcome was good. Emphysematous pyelonephritis is a rare upper urinary tract infection. Risk factors include diabetes and urinary obstruction. The diagnosis is made by computed tomography. Efficient antibiotics administration associated with collecting system drainage allow soon recovery and avoid nephrectomy

[Lumboscopic treatment of ureteral stones. About 31 cases]

The aim of our study is to state the efficiency and the place of lumboscopy in the treatment of ureteral stones. We report 31 cases of patients operated by lumboscopy for ureteral stones from January 2001 to December 2005. In most of cases, the indication is stone which size is higher than 15 mm. The mean operating time is 91 min and the rate of conversion to open surgery is 9, 7%. 9 [29%] postoperative complication is noted. The mean hospital stay is 5 days. No ureteral stricture or kidney destruction is noted with a mean follow-up of 34 months. Lumboscopy is a safe and effective technique in the treatment of the ureteral stones with a low rate of complications. It can replace open surgery in most of cases